First Online: 05 December 2011Received: 26 October 2011Accepted: 05 December 2011

Abstract

BackgroundPreservation of the Anterior Cruciate Ligament ACL remnant is important from the biological point of view as it enhances revascularization, and preserves the proprioceptive function of the graft construct. Additionally, it may have a useful biomechanical function. Double bundle ACL reconstruction has been shown to better replicate the native ACL anatomy and results in better restoration of the rotational stability than single bundle reconstruction.

MethodsWe used the far anteromedial FAM portal for creation of the femoral tunnels, with a special technique for its preoperative localization using three dimensional 3D CT. The central anteromedial AM portal was used to make a longitudinal slit in the ACL remnant to allow visualization of the tips of the guide pins during anatomical creation of the tibial tunnels within the native ACL tibial foot print. The use of curved hemostat allow retrieval of the wire loop from the apertures of the femoral tunnels through the longitudinal slit in the ACL remnant thereby, guarding against impingement of the reconstruction graft against the ACL remnant as well as the roof of the intercondylar notch.

ConclusionOur technique allows for anatomical double bundle reconstruction of the ACL while maximally preserving the ACL remnant without the use of intra-operative image intensifier.

Electronic supplementary materialThe online version of this article doi:10.1186-1758-2555-3-30 contains supplementary material, which is available to authorized users.